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If you did not act by December 7, you may still have options

Original Medicare

If you have Original Medicare with a stand-alone Prescription Drug Plan (PDP) and you did not change it by Dec. 7, it’s too late to change PDPs for 2021. This will be your plan for 2021 and you will have to pay the required copays unless you want to switch to the Kaiser Medicare Advantage plan using the 5-star special enrollment period option. Call HICAP for more information about that. Otherwise, see our handout on How to Save Money on Drugs for help with your prescription costs.

Medicare Advantage Plans

My Medicare Advantage plan premium or copays are increasing or my doctor is no longer in network!

If your current Medicare Advantage (MA) plan is increasing its premium or copays for next year you may have additional options. This applies to people with the AARP SecureHorizons Plan 1 or Focus, United Healthcare Canopy or Assure, and Kaiser Senior Advantage MA plans.

If you didn’t disenroll from your MA plan by December 7 you have another opportunity to do so during the MA disenrollment period between January 1 and March 31, 2021.

You can either disenroll from your MA plan and go back to Original Medicare with a drug plan and possibly a supplement, or you can change to a different MA plan. Even if you did change or newly enroll in a MA plan during 2020 open enrollment and now you have second thoughts, you can change again during the first quarter of 2021 or go back to Original Medicare with a drug plan. You have just one opportunity during this first quarter period to make a change.

The simplest way to change plans, either to a stand-alone drug plan or a different Medicare Advantage plan, is to enroll in a new plan. You will automatically be disenrolled from your old plan. If you take action during January your new coverage will be effective Feb. 1, 2021. If you take action during February your new coverage will be effective March 1, 2021 and if you take action during March your new plan will be effective April 1, 2021. If you disenroll from a MA plan and do not enroll in a prescription drug plan, you may be subject to a Part D late enrollment penalty and delay in coverage should you want Part D again later.

You also have some options to supplement your coverage if you disenroll from Medicare Advantage and go back to Original Medicare.

  • You can apply for a MediGap Supplement Plan from any company. You may or may not be guaranteed a plan depending on your situation.*
  • You can join a 5-star Medicare Advantage plan later at any time during the year. In Contra Costa County, Kaiser Senior Advantage Basic and Kaiser Senior Advantage Enhanced are the only 5-star plans

NOTE: MediGap plans do not cover prescriptions. You will need a separate Prescription Drug Plan.

*If you had the AARP SecureHorizons Plan 1 or Focus or the United Healthcare Canopy or Assure plan in 2020, you still have a guaranteed right to get a Medigap plan without health screening due to premium or copay increases in those plans. You can only get a Medigap from the same parent organization as your MA plan (AARP or UHC). You have until March 3, 2021 to apply for a Medigap from one of these companies.

If you had Kaiser Senior Advantage MAPD and you disenrolled by Dec. 7, 2020, you also have a guaranteed right to get a Medigap plan due to premium increases. In this case you can get a Medigap from any company, up until March 3, 2021. If you did not disenroll from Kaiser or by Dec. 7, then you can disenroll between Jan. 1 and March 31, 2020 and go back to Original Medicare with a PDP, but you do not have a guaranteed issue right to get a Medigap. In that case you may apply for one, but you will be subject to medical underwriting and may be denied.

If you don’t make a change by March 31, 2021, you will remain in your current MA plan for the rest of 2021 and will be required to pay the 2021 premium and copays.

How can I learn more and get help from HICAP?

If you need help you can Contact Us.

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